Bipolar Disorder

My best friend is bipolar and is pregnant with twins.  Her emotional health has been good for the past few years, but she had a psychotic break after her first child was born in '05.  I worry that it will happen again after she gives birth to the twins.

Since emotions and hormones change quickly during pregnancy and postpartum, is she at risk for another break after giving birth, or am I just being overly paranoid?

I'm worried about her.

Thanks.

Yes, a woman who had a psychotic break in a prior pregnancy is at risk for another one after the next pregnancy. This can be anticipated and planned for. The key is to weigh the risks of the illness versus the risks of medications (psychotherapy can help with no side effects). This is a complex formula and depends on many factors.  I would encourage your friend to get a consult from a psychiatrist as she plans her next pregnancy so she can reflect on her choices in advance of the pregnancy.